Adoption Application

Which animal are you applying to adopt? *

Full Name *

First Name Last Name

Address *

Phone Number *

- Area Code Phone Number

E-mail

Date of Birth *

- Month - Day Year

How many live in your home? *

Please list the ages of children in your home:

If you rent, what is the pet policy?

Landlord's Name

Landlord's Phone

- Area Code Phone Number

Current Pet Information

Past Pet Information

Please describe your knowledge of the care this animal will require *

Describe where your new pet will be living: *

How much do you think your new pet's care will cost each month? *

How will you handle any behavior issues that may arise? *

What reasons might prompt you to consider returning the animal? *

Current Vet's Name

Current Vet's Phone

- Area Code Phone Number

Please provide two references:

Name *

Phone Number *

- Area Code Phone Number

Name *

Phone Number *

- Area Code Phone Number

Thank you for considering adopting from A Critter's Chance!

This section to be filled out by A Critter's Chance Adoption Counselor:

Animal's Chip ID

Date of Adoption

- Month - Day Year